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Elastase secretion in pancreatic disease.

R Mizuno, T Hayakawa, A Noda

    The American Journal of Gastroenterology
    |February 1, 1985
    PubMed
    Summary
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    Elastase output in duodenal aspirates is a sensitive marker for pancreatic dysfunction. Lower elastase levels and elastase-to-amylase ratios effectively indicate exocrine insufficiency in pancreatic diseases.

    Area of Science:

    • Gastroenterology
    • Biochemistry
    • Diagnostic Medicine

    Background:

    • Pancreatic exocrine insufficiency (PEI) affects nutrient absorption and quality of life.
    • Accurate diagnosis of PEI is crucial for timely and effective management.
    • Current diagnostic methods may have limitations in sensitivity for mild cases.

    Purpose of the Study:

    • To evaluate the diagnostic utility of duodenal elastase output in a pancreozymin secretin test.
    • To compare the sensitivity of elastase with other pancreatic enzymes (amylase, chymotrypsin, trypsin, lipase) in detecting pancreatic dysfunction.
    • To assess the value of the elastase-to-amylase ratio as an index for pancreatic secretory capacity.

    Main Methods:

    • Duodenal aspirates were collected during a pancreozymin secretin test.

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  • Enzyme concentrations (elastase, amylase, chymotrypsin, trypsin, lipase) were measured.
  • Measurements were performed in 46 healthy controls and 61 patients with various gastrointestinal diseases, including chronic pancreatitis and pancreatic cancer.

    • Main Results:

    • Elastase output was significantly reduced in patients with chronic pancreatitis (mild and advanced), pancreatic cancer, and liver cirrhosis compared to controls.
    • Other enzymes also decreased in chronic pancreatitis and pancreatic cancer but not in liver cirrhosis.
    • Elastase showed higher sensitivity in detecting mild exocrine insufficiency compared to other enzymes.
    • The elastase-to-amylase ratio was significantly lower in pancreatic diseases.

    Conclusions:

    • Elastase is the most sensitive enzyme to pancreatic exocrine dysfunction.
    • Duodenal elastase output and its ratio to amylase output are valuable diagnostic indices for assessing pancreatic secretory capacity.
    • This test can aid in the early detection and management of pancreatic diseases.